The factors affecting substance abuse relapse based on theory of planned behavior in male addicts covered by addiction treatment centers in Southern Iran.

BACKGROUND: Given the destructive nature of addiction and its relapse after quitting, the present study aimed to investigate the factors affecting substance abuse relapse based on the Theory of Planned Behavior (TPB) in male addicts covered by addiction treatment centers in Shiraz, Iran. METHODS: This cross-sectional study was conducted on 400 male addicts covered by addiction treatment centers in Shiraz, Iran, in 2021-2022. The data collection tool was a researcher-made questionnaire. Data were analyzed using SPSS-22 software through descriptive statistical methods, linear regression, and binary logistic regression. RESULTS: 190 people (47.50%) were aged 31-40 years, 265 people (66.25%) were married, 224 people (56%) lived with their spouses, and 192 people (48 percent) had their first use at the age of 16-20. The substance respondents used were methamphetamine (59.5%), heroin (53%), opium (48%), and alcohol (40%). 138 people (34.5%) had their first place of consumption at friends' houses (Tables 1 and 2). 342 people (85.5%) had a history of relapse, and 172 people (50.29%) had 1-5 relapses. Marital status, occupation, and income were among the demographic risk factors, and addicted friends and close relatives were among the behavioral risk factors for drug relapse among people with a history of relapse. Personal desire and the insistence of friends were also among the individual and interpersonal factors of drug use among participants. The regression results showed that the constructs of awareness, attitude, subjective norms, perceived behavioral control, and behavioral intention were predictors of drug relapse among addicts (P < 0.05). CONCLUSION: The current study's findings indicate that among the behavioral risk factors for drug relapse in individuals with a history of relapse are addicted friends and close relatives, while marital status, occupation, and income are among the demographic risk variables. Among the individual and interpersonal factors influencing drug usage among participants were personal desire and friends' insistence. Furthermore, the findings indicated that the TPB's structures might be used to predict drug relapse in addicts.

Factors predicting self-care behavior of cardiovascular patients during the COVID-19 epidemic.

BACKGROUND: The COVID-19 virus has had wide-ranging effects on all healthcare systems and a direct impact on all areas of human life in all countries around the world. Therefore, it is necessary to take preventive actions to reduce the prevalence and severity of the complications associated with this disease. The purpose of this study was to explain the dimensions of adopting general self-care behaviors (mask-wearing, social distancing, hand hygiene, and home quarantine) for preventing COVID-19 based on the theory of planned behavior (TPB) in cardiovascular patients. METHODS: This was a descriptive-analytical study conducted with the participation of 420 patients referring to health and treatment centers of Ahvaz, southwest of Iran, in 2022. Sampling was done using a non-random (convenience) method. The data collection tool was a questionnaire containing items addressing demographic characteristics, questions related to the TPB, and questions dealing with the adoption of everyday self-care behaviors against contracting COVID-19. Data were analyzed using descriptive and inferential statistical methods (prevalence, mean, standard deviation, Pearson's correlation coefficient, and linear regression) in SPSS version 25. RESULTS: The results of this study showed that the rate of adoption of self-care behaviors against COVID-19 among cardiovascular patients was moderate. The results also showed that among the constructs of the TPB, Perceived behavioral control, Subjective norms, and Perceived behavioral intention were the most important predictors of adopting self-care behaviors among cardiovascular patients with a change variance of 46%. CONCLUSIONS: The results of the present study have implications for health and treatment policy makers as well as planners of educational and behavioral interventions aimed at promoting the adoption of self-care behaviors against COVID-19. In this respect, managing and institutionalizing desirable behaviors among cardiovascular patients could be beneficial from economic, social, and health-related aspects.

Perceptions of Chinese women with a history of gestational diabetes regarding health behaviors and related factors: a directed qualitative content analysis.

BACKGROUND: Gestational diabetes mellitus (GDM) is one of the most common metabolic disorders during pregnancy and is associated with adverse outcomes in both mothers and their children. After delivery, women who experience GDM are also at higher risk of both subsequent GDM and type 2 diabetes mellitus (T2DM) than those who do not. Therefore, healthcare providers and public health practitioners need to develop targeted and effective interventions for GDM. In this study, we aimed to explore the perceptions regarding health behaviors and related factors during the inter-pregnancy period among Chinese women with a history of GDM through the lens of the theory of planned behavior (TPB). METHODS: Between December 2021 and September 2022, 16 pregnant Chinese women with a history of GDM were purposively recruited from a tertiary maternity hospital in Shanghai for face-to-face semi-structured interviews. They were asked questions regarding their health behaviors and related factors. The transcribed data were analyzed using a directed qualitative content analysis method based on the theory of TPB. RESULTS: The health-related behaviors of the women varied substantially. We identified five domains that influenced women's behaviors according to TPB constructs and based on the data collected: behavioral attitude (perceived benefits of healthy behaviors and the relationship between experience and attitude towards the oral glucose tolerance testing); subjective norms (influences of significant others and traditional cultural beliefs); perceived behavior control (knowledge of the disease, multiple-role conflict, the impact of COVID-19, an unfriendly external environment and difficulty adhering to healthy diets), incentive mechanisms (self-reward and external incentives); preferences of professional and institutional support (making full use of social media platform and providing continuous health management). CONCLUSIONS: The health-related behaviors of women with a history of GDM were found to be affected by multiple factors. Healthcare professionals are recommended to provide women with sufficient information regarding the disease and to take advantage of the power of the family and other social support networks to improve women's subjective norms and to promote the adoption of a healthy lifestyle.

Physical Activity Promotion in Schools Using Theoretically Designed Mobile Phone Application.

Background: Regular physical activity for adolescents has many health benefits, many of which also affect adulthood. Physical activity is a behavior that requires planning and choosing an appropriate educational method, model, or theory. However, mobile phone applications are known as a suitable method to increase physical activity according to the guidelines. This study aims to increase physical activity in female students based on the theory of planned behavior using mobile phone applications. Methods: This quasi-experimental study was implemented on 220 high school students (110 people in each group). The samples were selected by a multi-stage cluster method and their information was collected by the International Physical Activity Questionnaire (IPAQ) and the Theory of Planned Behavior (TPB) questionnaire whose validity and reliability were confirmed. The intervention group received 8 sessions of education through a mobile phone application that was designed by the constructs of the theory of planned behavior. The samples were evaluated in three stages, through a pre-test, post-test, and two-month follow-up. Results: The results showed a significant difference in the post-test and two months after the intervention between intervention and control groups in terms of attitude, perceived behavioral control, intention, and physical activity. There was a significant difference between intervention and control groups in subjective norms in the post-test, but there was no significant difference in the two-month follow-up compared to the post-test (P = 0.08). Conclusions: An educational intervention based on the theory of planned behavior using mobile phone applications led to an increase in the physical activity of girl high school students. However, to determine the full effectiveness of this study, it is recommended to implement this intervention in all schools.

Barriers and motivational factors for engaging in novel opioid and medication disposal-related services in community pharmacies.

OBJECTIVE: This study aimed to explore and identify motivational factors and barriers for pharmacy personnel participation in specific opioid mitigation programs, using the Theory of Planned Behavior (TPB) as an investigational framework. METHODS: A naturalistic inquiry method was employed involving semi-structured interviews with pharmacy personnel to assess their intentions, attitudes, normative beliefs, and behaviors towards participating in naloxone dispensing and provision of at-home drug disposal solutions. Purposive sampling was utilized to recruit participants, with saturation achieved after 12 interviews. Interviews were transcribed and coded to identify recurring themes. RESULTS: Four primary themes emerged: 1) the value and benefits of helping others, emphasizing societal, patient, and environmental benefits; 2) limits and barriers to participation, including financial concerns, management support, and time constraints; 3) pharmacists' intrinsic motivators, highlighting personal motivations and differentiation between programs for specific patient types; and 4) program implementation challenges and strategies. CONCLUSION: The findings underscore the applicability of the TPB in understanding pharmacy engagement in opioid abatement programs. Despite facing barriers such as financial considerations and time constraints, the overall positive attitudes towards the programs indicate a strong motivation to contribute to public health efforts. Addressing identified barriers and leveraging motivators could enhance participation, potentially mitigating the opioid crisis. Future research should incorporate patient perspectives to fully understand the impact and effectiveness of pharmacy-led interventions, such as naloxone dispensing and disposal solutions, in opioid misuse prevention.

Exploring waste separation using an extended theory of planned behavior: a comparison between adults and children.

This study applied an extended model of the theory of planed behavior (TPB) to compare the differences in waste separation behavior between children (ages 9 to 12, N = 339) and adults (ages 18 to 66, N = 379). We examined the relations among waste separation attitude, subjective norm, perceived behavioral control, knowledge, awareness, intention, and behavior. The results showed waste separation knowledge of children was less than that of adults. Structure equation model results also revealed robust differences between children and adults. For adults, TPB variables (attitude, subjective norm, and perceived behavioral control) and knowledge are significantly positively related to their waste separation intention. Meanwhile, perceived behavioral control and intention are positively related to adults' behavior. However, for children, only perceived behavioral control and awareness are positively related to intention, and perceived behavioral control is positively related to behavior. Moreover, the predictive power of the extended TPB model on children's waste separation intention and behavior are lower than those of adults. The different results may be due to children's immature cognitive abilities. This study enhanced the understanding of the different waste separation behavior determinants between children and adults. The findings are useful for developing tailored policies and promoting children's waste separation behavior.

Factors affecting the intention to wear helmets for e-bike riders: the case of Chinese college students.

As the popularity of electric bicycles (e-bikes) continues to surge, the number of accidents involving them has commensurately increased. A significant factor contributing to the high fatality rate in these accidents is the low usage of helmets among e-bike riders. Helmets have been proven to reduce the severity of injuries, yet their usage remains unexpectedly low. This issue is particularly pronounced among college students, the primary buyer group for e-bikes. Regrettably, there is a lack of research exploring their intentions to wear helmets. Understanding determinants of their intentions to wear helmets is crucial in promoting safe e-bike travel. Therefore, the present study aims to develop an integrated theoretical model that combines the Theory of Planned Behavior (TPB) and the Health Belief Model (HBM) to examine the factors influencing e-bike riders' helmet-wearing intentions among college students. Additionally, two variables-descriptive norms and law enforcement-are incorporated. The results indicate that the integrated model accounts for 76% of the variance in helmet-wearing intention, surpassing single-theory models. Specifically, the TPB accounts for 65%, while the HBM explains 53%. Notably, law enforcement emerges as the most influential factor, highlighting the crucial role of enforcing regulations and promoting awareness. Other significant factors include subjective and descriptive norms, attitudes, perceived benefits, perceived susceptibility, perceived barriers, and perceived severity. These findings provide valuable insights for policy development and targeted interventions aimed at improving helmet wear rates among e-bike riders, especially among the college student population.

Beliefs and Perceptions of Physical Activity Among Black Adolescents in South Florida: A Qualitative Study.

INTRODUCTION: In the United States, non-Hispanic Black adolescents have a significantly higher prevalence of obesity than their peers. Though physical activity (PA) has many benefits, many adolescents fail to engage in adequate amounts of PA. Black adolescents are also more sedentary than those from other races and ethnicities. This study aimed to describe the perceptions, beliefs, and barriers to PA in South Florida Black adolescents. METHODS: Five focus groups were conducted with self-identified non-Hispanic Black adolescents (n = 38) in South Florida. A semi-structured question guide based on the Theory of Planned Behavior was used for group discussions. The open-ended questions addressed adolescents' (1) attitudes and beliefs toward PA, (2) current PA-related behaviors, and (3) environmental, social, cultural, and racial influences on health behaviors. RESULTS: The desire to be healthy, thoughts of the future, and self-image were among the reasons participants engaged in PA. Engagement in PA was associated with a positive social environment, including encouragement from family and friends. Race, culture, and social media were also cited as influences on PA. Perceived control beliefs, such as parental pressures and self-discipline, also impacted PA. CONCLUSION: Adolescents recognize the importance of PA; however, their behaviors do not reflect this. Barriers and motivators for Black adolescents are multifaceted. It is critical for Public Health practitioners and local legislators to understand the complexities to serve this population. This study's findings can guide the development of tailored PA and education programs for Black adolescent populations.

The Effect of a Training Program Based on the Theory of Planned Behavior on the Self-Care of Patients with Cerebrovascular Accident: A Randomized Controlled Trial.

Background: Cerebrovascular accident dramatically impacts patients' lives. However, this chronic disease could be managed by boosting self-care and following healthy behaviors. Accordingly, this trial sought to specify the impact of a training program established on the theory of planned behavior on the self-care of clients with this condition. Materials and Methods: This trial was performed on 80 clients, who were selected using a random numbers table and divided into two equal groups to receive either usual care alone or usual care plus a training program based on the theory of planned behavior (five in-hospital individual sessions for 5 weeks and weekly phone follow-ups for 2 months after discharge). Self-care and the dimensions of the theory of planned behavior were investigated at baseline and 2 months after the last in-hospital session using the standardized Shah version of the modified Barthel index and a researcher-made questionnaire, respectively. Results: The mean score of self-care was significantly higher in the experimental arm at the posttest (Mann-Whitney = 506.00, p = 0.005). Also, the increase in mean change of self-care from baseline to posttest was significantly more in the experimental arm (t78= -6.6, p < 0.001). Such findings were also found for all dimensions of the theory of planned behavior. Conclusions: Based on results, nurses and health policymakers can incorporate training based on the theory of planned behavior into routine care programs for patients with cerebrovascular accident to boost their self-care. The implemented intervention also could be reproduced in other contexts. Hence, further trials are requested to specify the sustainability of the findings.

The perceived influence of a physical activity intervention on the intentions of parents of autistic children towards physical activities.

BACKGROUND: Autistic children can derive numerous benefits from engaging in physical activity (PA), necessitating parental support for active participation. However, parents often lack the foundational knowledge to effectively facilitate PA for their children. Despite the significance of this issue, limited research has explored the outcomes of parent-mediated PA interventions for autistic children. OBJECTIVE: The purpose of this study was to examine the attitudes and intentions of parents to include their autistic children in PA after participating in a 12-week PA intervention. METHODS: Employing the Theory of Planned Behavior as a framework, we conducted a descriptive-qualitative investigation. Fifteen parents participated in semi-structured interviews, with the data transcribed and analyzed using thematic line-by-line analysis. RESULTS: Three themes emerged, elucidating how parents fostered PA opportunities for their autistic children were constructed: (a) Awareness and reinforcement of PA benefits, (b) Keep the momentum going, and (c) From intentions to behaviors. CONCLUSIONS: The study findings indicate a positive impact on parental attitudes and intentions toward engaging in PA with their autistic children after participating in the intervention. his study highlights the significance of parent-mediated interventions in fostering PA for autistic children and suggests avenues for future research and interventions.

How to reduce the carbon footprint of the agricultural sector? Factors influencing farmers' decision to participate in carbon sequestration programs.

Mitigating climate change by sequestering carbon in agricultural soils through humus formation is a crucial component of sustainable agriculture. Humus programs that are designed to incentivize farmers to build more humus are still recent innovations, so current knowledge about farmers' motivation to participate is limited. This study examines the adoption of non-governmental humus programs to promote carbon sequestration by analyzing farmers' willingness to participate in humus programs and influential factors. We specifically investigate behavioral factors underlying farmers' adoption of humus programs using the Theory of Planned Behavior. To this end, we collected data using an online survey with 190 German farmers and applied partial least squares structural equation modeling. The results show that (i) perceived economic benefits, (ii) the actions of fellow farmers, and (iii) farmers' sense of responsibility with regard to climate change have a statistically significant influence on farmers' intention to participate in a humus program. In contrast, the perceived ecological benefits, political pressure, the possibility of establishing humus-building measures, and prior knowledge of humus programs have no statistically significant influence. Our findings suggest that farmers' decision to participate in humus programs is strongly influenced by the financial benefits, but the actions and thoughts of other farmers, as well as their own moral claims regarding climate change, also play a crucial role. We found that farmers lack knowledge about the registration and general functioning of humus programs, which can currently be one of the biggest barriers to participation in such initiatives.

Physicians' intentions to use digital tools - a comparative survey, before and after the COVID-19 pandemic, in Southern Sweden.

OBJECTIVES: To describe changes in Swedish primary care physicians' use of, attitudes and intentions toward digital tools in patient care between 2019 and 2022. DESIGN: A survey using a validated questionnaire measuring physician's intentions to use digital tools based on the theory of planned behavior. SETTING: Sample of primary health care centers in southern Sweden. SUBJECTS: Primary care physicians. MAIN OUTCOME MEASURES: Self-reported use and intentions to use, digital tools including digital consultations by text or video, chronic disease monitoring and artificial intelligence (AI) and the associations between attitudes, subjective norms, perceived behavioral control and behavioral intentions to use digital tools, in 2019 compared to 2022. RESULTS: In both 2019 (n = 198) and 2022 (n = 93), physicians reported high intentions to use digital tools. Self-reported use of video was slightly higher in 2022 (p = .03). No other changes were seen in the self-reported use or behavioral intentions to use digital tools. CONCLUSION: The slow adoption of patient-related digital tools in Swedish primary health care does not seem to be explained by a low intention to use them among physicians. Future research on implementation of digital tools should include a focus on contextual factors such as organizational, technical and cultural barriers.

Based on the theory of planned behavior a survey was designed and applied in 2019 to measure physicians' use of, attitudes and intentions toward telemedicine (PAIT) and digital tools.A follow up study using PAIT was conducted in 2022.Physicians reported high intentions to use digital tools in both 2019 and 2022.Self-reported use of digital tools was low in both 2019 and 2022.

Factors influencing civil servants' willingness to implement cardiopulmonary resuscitation in Chongqing, China: Based on the theory of planned behavior.

Background: Timely bystander cardiopulmonary resuscitation is the key to improving the survival rate of out-of-hospital cardiac arrest. Civil servants are potential bystander CPR providers. This study aimed to explore civil servants' willingness to implement CPR in Chongqing, identify the influencing factors and mechanisms affecting civil servants' willingness to perform CPR, and then seek countermeasures to improve civil servants' willingness to implement CPR. Methods: We introduced the theory of perceived risk into the theory of planned behavior, developed a 7-point Likert scale based on the extended theory of planned behavior, and conducted a questionnaire survey on civil servants in Chongqing, China. Descriptive statistical analysis and one-way ANOVA were employed to explore respondents' willingness and differences. Structural equation modeling was used to analyze the relationship between attitude, subjective norm, perceived behavioral control and perceived risk and respondents' willingness to implement CPR. Results: A total of 1235 valid questionnaires were included for analysis. 50.1 % of respondents were willing to implement CPR. Male, over 40 years old, living with the elderly, having previous experience performing CPR on another person, and having higher CPR knowledge scores were associated with a more positive willingness to perform CPR. Attitude, subjective norm and perceived behavioral control had significant positive effects on willingness, and the standardized regression coefficients were 0.164, 0.326 and 0.313, respectively. The perceived risk has a significant negative effect on willingness, and the standardized regression coefficient was -0.109. The four latent variables accounted for 44.2 % of the variance in the willingness of civil servants to implement CPR. Conclusions: The willingness of civil servants in Chongqing to implement CPR needs to be improved, and the countermeasures to enhance the subjective norm and perceived behavioral control of civil servants should be emphasized, such as developing a social support network for rescuing conduct, establishing regular training mechanisms and improving the practical applicability and popularization of the Chinese-style "Good Samaritan Law" etc., to improve the willingness of civil servants in Chongqing to implement CPR.

Analysis of Actual Fitness Supplement Consumption among Health and Fitness Enthusiasts.

With the rising popularity of fitness supplements, understanding the factors driving their consumption behaviors is crucial. This study investigated the actual consumption of fitness supplements utilizing the Theory of Planned Behavior (TPB), Health Belief Model (HBM), and the Theory of Effort Minimization in Physical Activity (TEMPA) frameworks. The TPB provided insights into how attitudes, subjective norms, and perceived behavioral control influence individuals' intentions to consume fitness supplements. Additionally, the HBM sheds light on perceived effectiveness, benefits, barriers, and health motivation related to supplement consumption. Integrating the TEMPA framework further investigated the role of effort minimization in physical activity contexts. Through an online questionnaire, data were collected from a sample of 250 fitness supplement-consuming respondents. SEM analysis revealed significant associations between behavioral intentions and attitudes, perceived behavioral control, health motivation, and controlled precursors. However, it was seen that subjective norms, perceived effectiveness, perceived benefits, and automatic precursors were deemed insignificant. The findings contribute to a comprehensive understanding of the factors shaping actual consumption behaviors, offering valuable implications for marketers, health professionals, and policymakers seeking to promote informed and responsible supplement use among health and fitness enthusiasts.

Influencing factors of health screening among retirees: an extended TPB approach.

Background: Health screenings are promoted worldwide as they help detect and prevent overall health issues. Despite expanding coverage, the participation rate among the retired population has not significantly increased. Given the special role of health screenings in promoting health and healthy aging, understanding the behavioral intentions, and influencing factors of retirees' voluntary participation in health screenings is crucial. This study aims to explore the participation intentions in health screenings among the Chinese retired population by integrating the Theory of Planned Behavior (TPB) and Self-Efficacy (SE). Methods: This study used a cross-sectional design to conduct an online questionnaire among 311 retirees in 2023. The questionnaire, tailored for the Chinese retired population, combines the TPB theory and Self-Efficacy theory, including demographic structure, the basic structure of TPB, and SE. Results: A Structural Equation Modeling (SEM) approach was used to identify factors related to health screening behaviors. Of the respondents, 311 completed the survey (88.9% response rate). The most crucial determinant of health examination behavior was behavioral intention, with a correlation score of (1.524, p < 0.001). Significant correlates of behavioral intention included Subjective Norms (SN) and Self-Efficacy (SE), followed by Perceived Behavioral Control (PBC) and Attitude (AT), with correlation scores of (0.401, p < 0.001), (0.339, p < 0.001), (0.082, p < 0.001), and (0.060, p < 0.05), respectively. Conclusion: This study provides insights for enhancing the willingness and behavior of retirees to participate in health screenings.

Exploring Physical Education Teachers' Intention and Perceived Constraints in Offering Online Lessons Using the Theory of Planned Behavior: A Multi-Country Analysis.

Guided by the theory of planned behavior, this study aimed to determine the influence of Physical Education (PE) teachers' attitudes, their perceived behavioral control, and the influence of subjective norms on their intention and constraints (intrapersonal, interpersonal, and structural) to offer a high-quality class based on best practices to deliver PE lessons online during the COVID-19 pandemic. This cross-sectional, multi-country survey study recruited PE teachers from five countries (China, Malaysia, the Philippines, Turkey, and the United States). A total of 928 online questionnaires were used in the analysis. In terms of the overall intention to teach online, our findings showed that American and Filipino teachers had higher levels of intention to continue teaching online. In contrast, Turkish, Malaysian, and Chinese teachers showed a lower interest. Moreover, Malaysian teachers had more intrapersonal constraints while the teachers in the other four countries were not as restrained intrapersonally. The results highlight the significant influence of perceived behavioral control and attitudes on PE teachers' intention to deliver online courses. Constraints to online teaching had a considerably large negative impact on attitudes, subjective norms, and perceived behavioral control. Based on the results, the proposed extension to the theory of planned behavior was an appropriate framework for understanding the behavioral intent of PE teachers.

The Role of Triggers in Physical Activity among College Students: An Extended Model of the Theory of Planned Behavior.

OBJECTIVE: This study aims to extend the Theory of Planned Behavior with Triggers (TPBT) to improve the prediction of physical activity (PA) behavior using the TPB model. METHODS: Questionnaires, including the TPB scale, PA rating scale (PARS-3), and triggers scale, were administered to 596 Chinese college students, and the data were analyzed using SPSS 23.0 and AMOS 24.0. RESULTS: Subjective norm (SN), attitude (AT), and perceived behavioral control (PBC) all significantly and positively affected behavioral intention (BI). The path coefficient of PA behavior was significantly influenced by the interaction term of three types of triggers and BI, and the TPB with Triggers (TPBT) model improved the explanation rate of PA behavior. CONCLUSION: Triggers have a moderating effect on the relationship between BI and PA behavior, and the TPBT model better explains college students' PA behavior. Among the three dimensions of triggers, people are more receptive to facilitator and signal triggers than spark triggers. This has practical implications for practitioners designing interventions to promote PA among college students.

Explaining citizens' plastic reduction behavior with an extended theory of planned behavior model: An empirical study in Switzerland.

The growing volume of plastic waste resulting from human activities is suffocating our planet. To combat this escalating issue, this study delves into the formation of plastic reduction behavior among Swiss citizens using an extended theory of planned behavior model. Through an online survey, the study obtained 149 valid responses, which were analyzed using partial least squares-based structural equation modeling. The results indicate a significant and strong relationship between plastic risk perception and attitudes towards plastic reduction and environmental protection. Notably, the cognitive dimension (ß = 0.802, p = 0.000) of plastic risk perception exhibits a tighter and stronger association with attitude compared to the emotional dimension (ß = 0.406, p = 0.000). Among the three variables in the theory of planned behavior model, perceived behavioral control (ß = 0.384, p = 0.000) emerges as the strongest determinant of behavioral willingness for plastic reduction. It is followed by attitude (ß = 0.214, p = 0.030). However, no significant relationship is observed between subjective norm and behavioral willingness for plastic reduction (ß = 0.07, p = 0.292). Finally, attitude fully mediates the relationship between plastic risk perception and behavioral willingness for plastic reduction. Theoretical and managerial implications are discussed.

Differences in influencing mechanism of clinicians' adoption behavior for liver cancer screening technology between the leading and subordinate hospitals within medical consortiums.

BACKGROUND: Medical consortiums have been extensively established to facilitate the integration of health resources and bridge the technical gap among member institutions. However, some commonly appropriate technologies remain stagnant in subordinate hospitals, although they have been routinely applied in leading hospitals. Besides, the mechanism underlying differences in clinicians' adoption behavior at different levels of institutions was unknown. Therefore, this study aimed to investigate the differences in influencing mechanisms of clinicians' hepatic contrast-enhanced ultrasound technology (CEUS) utilization behavior between leading and subordinate hospitals within medical consortiums, thus providing clues for expanding effective and appropriate technologies within integrated care systems. METHODS: A self-designed scale was developed based on the theory of planned behavior (TPB). A multistage sampling method was applied to investigate clinicians who were aware of CEUS and worked in liver disease-related departments within the sampled medical institutions. The final sample size was 289. AMOS 24.0 software was used to construct multi-group structural equation modeling (SEM) to validate the hypotheses and determine the mechanism of hepatic CEUS utilization. RESULTS: It revealed that behavioral intention significantly influenced adoption behavior, regardless of whether it was in leading hospitals or subordinate hospitals (ß = 0.283, p < 0.001). Furthermore, behavioral attitude (ß = 0.361, p < 0.001) and perceived behavioral control (ß = 0.582, p < 0.001) exerted significant effects on adoption behavior through behavioral intention. However, in leading hospitals, subjective norm had a significant positive effect on behavioral intention (ß = 0.183, p < 0.01), while it had a significant negative impact on behavioral intention in the subordinate hospitals (ß = -0.348, p < 0.01). CONCLUSION: To effectively translate the adoption intention into actual behavior, it is recommended to elucidate the demand and facilitators involved in the process of health technology adoption across leading and subordinate hospitals. Additionally, bolstering technical support and knowledge dissemination within subordinate hospitals while harnessing the influential role of key individuals can further enhance this transformative process.

The impact of environmental accidents on the green apparel purchase behavior of Generation Z.

Introduction: This study examines the impact of environmental accidents on Generation Z's purchase behavior towards green apparel, integrating the Theory of Planned Behavior and the Norm Activation Theory to conceptualize how different dimensions of environmental accidents influence consumer behavior. Methods: Employing focus groups and questionnaires, this research captures data on Generation Z's perceptions and behaviors towards green apparel in the context of environmental accidents. The collected data were analyzed using SPSS software, with structural equation modeling employed to test the research hypotheses. Results: The findings indicate that the scale (H12 = 0.545), the degree of suddenness (H18 = 0.357), nature of the effect (H14 = 0.295), and duration (H17 = 0.289) of environmental accidents significantly influence Generation Z's awareness of consequences, behavioral attitudes, subjective norms, and perceived behavioral control regarding the purchase of green clothing. Notably, the scale of environmental accidents has a significant impact on perceived behavioral control, which in turn significantly affects Generation Z's intention to purchase green apparel (H3 = 0.5). Discussion: This study elucidates the impact of environmental accidents on Generation Z's green apparel purchase intentions. The findings highlight Generation Z's environmental awareness and social responsibility, influencing their purchasing decisions. This research offers practical insights for brands to enhance green marketing strategies, focusing on product quality, transparency, and consumer education to align with Generation Z's values and expectations. Future research should explore additional factors affecting purchase behavior and strategies to bridge the intention-behavior gap.